Provider Demographics
NPI:1588205710
Name:ABEYTA, BENJAMIN CRUZ
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:CRUZ
Last Name:ABEYTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 GALAPAGO ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-3942
Mailing Address - Country:US
Mailing Address - Phone:303-504-6800
Mailing Address - Fax:
Practice Address - Street 1:1075 GALAPAGO ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3942
Practice Address - Country:US
Practice Address - Phone:303-504-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-29
Last Update Date:2019-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide